North Jersey doctors suggest psychotherapy to help treat anxiety disorders

Some stage fright can enhance your performance, for example. A few butterflies could propel you across the finish line. Too much, however, can be crippling.

"It's a terrible thing," said a 59-year-old Paramus man who has been suffering from anxiety for 10 years (he asked that his name not be used). "I'll be sleeping, and I'll wake up sweating. I'll think about my life, I'll think about life itself. I'll think about the past, I'll think about the future. I'll think about everything."

He's hardly alone. About 40 million American adults suffer from an anxiety disorder, such as generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder and social phobia, according to the National Institute of Mental Health. Collectively, they are the most common mental disorders in the U.S.

"Anxiety is a normal reaction that we all feel," said Dr. Diego Coira, chairman of Hackensack University Medical Center's department of psychiatry and behavioral sciences. "It becomes a disorder when that fear of something happening is a perception not based on reality."

Anxiety disorders — particularly panic attacks — can have both physical and emotional symptoms, according to the Anxiety and Depression Association of America, including increased worry or tension, heart palpitations, sweating, shortness of breath and dizziness.

Melissa, a 32-year-old woman from Midland Park, suffered from panic attacks so severe, they felt like heart attacks. "It always felt like somebody was standing on my chest," she said.

She was so afraid of going out in public that for a few years she didn't leave her house unless it was "absolutely" necessary. Though she suffered with anxiety since childhood, Melissa said it escalated when she was on prescription painkillers a few years ago for back problems.

"I was at the point pretty much where I didn't care whether I woke up the next morning," she said. "It's not a life that anybody should have. It's terrible, it's lonely."

Coira and Dr. Sharad Wagle, chief of psychiatry at Holy Name Medical Center, point to anxiety's roots as a survival instinct. For animals in the wild, it's a skill that's necessary to fend off predators – but only in the right balance.

"Too little anxiety is not good because you'll basically get slaughtered," Wagle said. "Too much anxiety, you're frozen with fear."

There are situations where being anxious is natural, Wagle noted, such as walking through a rough neighborhood known to be violent. But if you're consistently feeling panic-stricken, even while in a safe environment, you likely have an anxiety disorder.

"If you constantly see that it's at a level 10 on a scale of 0 to 10, then you know that this can't be real danger," Wagle said. "Most people don't face level 10 danger on a regular basis, unless you're in the military or on a front line of a war, or something like that."

Like depression, many people with anxiety are able to hide their disorder and somehow function on a high level, even though underneath their calm exterior they are a bundle of nerves. "Anxiety is more common than we think," Coira said. "Many people are able to go through life with anxiety."

In his recently published book, "My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind." Scott Stossel, editor of The Atlantic magazine, writes about the tyranny of his anxiety.

"I am, as they say in the clinical literature, 'high functioning' for someone with an anxiety disorder or other mental illness; I'm usually quite good at hiding it. This is a signature characteristic of the phobic personality: 'the need and the ability,' as described in the self-help book 'Your Phobia,' 'to present a relatively placid, untroubled appearance to others, while suffering extreme distress on the inside,'" Stossel wrote in an essay for The Atlantic, adapted from his book. "To some people, I may seem calm. But if you could peer beneath the surface, you would see that I'm like a duck — paddling, paddling, paddling."

Stossel also suffers from several phobias, including emetophobia, the fear of vomiting – though he hasn't thrown up since 1977, when he was 7 years old.

"I stash motion-sickness bags, purloined from airplanes, all over my home and office and car in case I'm suddenly overtaken by the need to vomit," he wrote. "I carry Pepto-Bismol and Dramamine and other antiemetic medications with me at all times."

For ABC News reporter Elizabeth Vargas, alcohol was a way to deal with her anxiety and panic attacks. The "20/20" anchor recently opened up about her addiction on "Good Morning America."

"I dealt with that anxiety, and with the stress that the anxiety brought, by starting to drink," she had said. "And it slowly escalated and got worse and worse."

Many people turn to alcohol or drugs to self-medicate, Wagle and Coira said.